{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:24:35Z","timestamp":1776133475690,"version":"3.50.1"},"reference-count":28,"publisher":"Federacion Colombiana de Obstetricia y Ginecologia","issue":"2","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["revista.fecolsog.org"],"crossmark-restriction":false},"short-container-title":["Rev. Colomb. Obstet. Ginecol."],"abstract":"<jats:p>AntecedentesA partir del 2014 en Colombia se incorpor\u00f3 la Tamizaci\u00f3n primaria con prueba de Virus del Papiloma Humano (VPH) desde los 30 hasta los 65 a\u00f1os, cuando la prueba es positiva se hace triage con citolog\u00eda para remisi\u00f3n a colposcopia. Actualmente se discute la conveniencia de iniciar la tamizaci\u00f3n con prueba de ADN de VPH a partir de los 25 a\u00f1os. De esta manera, el objetivo de esta evaluaci\u00f3n de tecnolog\u00edas sanitarias es analizar la evidencia disponible en torno a la seguridad, efectividad, costoefectividad, valores y preferencias, dilemas \u00e9ticos y aspectos relacionados con la implementaci\u00f3n para el contexto colombiano de la prueba ADN-VPH como estrategia de tamizaci\u00f3n cervical en mujeres menores de 30 a\u00f1os.\nDominios a evaluarEficacia cl\u00ednica y seguridad1. Tasa acumulada de neoplasia intraepitelial cervical (NIC) grado 2 o m\u00e1s avanzado luego de 2 rondas de tamizaci\u00f3n.2. Tasas acumuladas de c\u00e1ncer invasor de c\u00e9rvix luego de 2 rondas de tamizaci\u00f3n.3. Seguridad: remisi\u00f3n a colposcopia.\nCosto-efectividadCosto efectividad para Colombia.\nOtros dominios consideradosAspectos \u00e9ticos asociados a la tamizaci\u00f3n cervical en mujeres menores de 30 a\u00f1os. Aspectos organizacionales y del individuo. Barreras y facilitadores relacionados con la implementaci\u00f3n en el contexto colombiano de la tamizaci\u00f3n cervical en mujeres menores de 30 a\u00f1os.\nM\u00e9todos\nEvaluaci\u00f3n de efectividad y seguridad cl\u00ednicasSe realiz\u00f3 una b\u00fasqueda sistem\u00e1tica de la literatura en MEDLINE, Embase y CENTRAL de revisiones sistem\u00e1ticas y ensayos cl\u00ednicos. Se calific\u00f3 el cuerpo de la evidencia con la aproximaci\u00f3n GRADE. Posteriormente, se convoc\u00f3 a un grupo interdisciplinario a una mesa de trabajo en donde se present\u00f3 la evidencia recuperada, dando paso a la discusi\u00f3n y a la construcci\u00f3n de las conclusiones, siguiendo los lineamientos de un consenso formal acorde a la metodolog\u00eda RAND\/UCLA.\nEstudio econ\u00f3micoSe hizo una b\u00fasqueda sistem\u00e1tica de la literatura de estudios que hubieran evaluado el costo-efectividad para Colombia.\nResultadosDe 7.659 referencias recuperadas se incluyeron 8 estudios.\nResultados cl\u00ednicosSe realiz\u00f3 un an\u00e1lisis integrativo de 5 ensayos cl\u00ednicos aleatorizados que cumplieron con los citerios de inclusi\u00f3n. Cuando se compara frente a la citolog\u00eda, la tamizaci\u00f3n primaria con ADN-VPH en mujeres menores de 30 a\u00f1os, podr\u00eda asociarse con una mayor frecuencia de detecci\u00f3n de lesiones NIC2+ durante la primera ronda de cribado (RR: 1.57; IC: 1,20 a 2,04; certeza en la evidencia baja), con una menor incidencia de NIC2+ (RR:0,67; IC: 0,48 a 0,92; certeza en la evidencia baja) y se asocia con una menor frecuencia de carcinoma invasor al t\u00e9rmino del seguimiento (RR: 0,19; IC: 0,07 a 0,53; certeza en la evidencia alta).\nResultados econ\u00f3micosDesde el punto de vista econ\u00f3mico, la alternativa de ADN-VPH y triage con citolog\u00eda desde los 25 a\u00f1os quiz\u00e1s representa la alternativa m\u00e1s costo-efectiva para Colombia (raz\u00f3n costo-efectividad incremental $8.820.980 COP a\u00f1o 2013).\nOtras implicacionesDos estudios sugieren que las barreras de implementaci\u00f3n, atribuibles a circunstancias de intermediaci\u00f3n, de orden p\u00fablico y de car\u00e1cter geogr\u00e1fico, podr\u00edan ser solventadas por nuevas tecnolog\u00edas o estrategias de cribado. Es importante considerar alternativas de forma de administraci\u00f3n y de prestaci\u00f3n de servicios para solventar algunas barreras de aceptabilidad y acceso. Todo programa de tamizaci\u00f3n cervical debe contemplar los principios \u00e9ticos de no maleficencia, beneficencia, autonom\u00eda y equidad. Futuros estudios deben enfocarse en analizar nuevas tecnolog\u00edas de cribado con \u00e9nfasis en poblaci\u00f3n menor de 30 a\u00f1os.\nConclusionesEl uso de la prueba ADN-VPH como estrategia de tamizaci\u00f3n en mujeres menores de 30 a\u00f1os es una intervenci\u00f3n probablemente efectiva y costoefectiva para Colombia. Futuros estudios deben enfocarse en analizar nuevas tecnolog\u00edas de cribado con \u00e9nfasis en poblaci\u00f3n menor de 30 a\u00f1os.<\/jats:p>","DOI":"10.18597\/rcog.3866","type":"journal-article","created":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T19:11:07Z","timestamp":1658862667000},"page":"203-222","update-policy":"https:\/\/doi.org\/10.18597\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Tamizaci\u00f3n primaria con prueba ADN-VPH en mujeres menores de 30 a\u00f1os: evaluaci\u00f3n de tecnolog\u00eda sanitaria"],"prefix":"10.18597","volume":"73","author":[{"given":"Carmen Doris","family":"Garz\u00f3n-Olivares","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5355-729X","authenticated-orcid":false,"given":"Carlos Fernando","family":"Grillo-Ardila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4227-585X","authenticated-orcid":false,"given":"Jairo","family":"Amaya-Guio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9112-9958","authenticated-orcid":false,"given":"Maria Teresa","family":"Vallejo-Ortega","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7388-0385","authenticated-orcid":false,"given":"Luz Amparo","family":"Diaz-Cruz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7845-2416","authenticated-orcid":false,"given":"Carolina","family":"Fern\u00e1ndez-Motta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3068-758X","authenticated-orcid":false,"given":"Alejandra del Pilar","family":"Gomez-Motta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-9472","authenticated-orcid":false,"given":"Alina Tatiana","family":"Barrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0356-957X","authenticated-orcid":false,"given":"Lina Mar\u00eda","family":"Trujillo-S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3457-2499","authenticated-orcid":false,"given":"Carlos Humberto","family":"P\u00e9rez-Moreno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7030-477X","authenticated-orcid":false,"given":"Luis Jairo","family":"Bonilla-Osma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robinson","family":"Fern\u00e1ndez-Mercado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7147-7725","authenticated-orcid":false,"given":"N\u00e9stor Augusto","family":"Giraldo-M\u00e9ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6489-9479","authenticated-orcid":false,"given":"Jorge Eduardo","family":"Caro-Caro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-031X","authenticated-orcid":false,"given":"Amparo Leonor","family":"Ram\u00edrez-Corredor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6977-0578","authenticated-orcid":false,"given":"Dayanne Milecsy","family":"Rodr\u00edguez-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7913","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"90257","doi-asserted-by":"crossref","unstructured":"Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Pi\u00f1eros M, Znaor A, et al. 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